The present invention relates to a thoraco-lumbo-sacral orthosis for supporting a patient""s back and spine, and more particularly relates to a flexible adjustable brace that may be quickly and individually tailored to a patient""s physique and condition.
Various types of body braces have been used for many years to aid in the rehabilitation of the spine. These braces traditionally comprise rigid bodies having integrated splints. Due to the limitations of these types of braces, elderly, disabled, and severely injured persons often experience great difficulty in adjusting, fastening, and wearing these types of body braces.
One alternative to rigid body braces are soft, flexible body braces. The typical flexible body brace uses corset lacings and buckles or snaps to fasten together the various portions of the brace. The corset lacings, buckles, or snaps require constant adjustment to provide maximum comfort and support for the wearer. Further, buckles and snaps may only be adjusted in quantum increments, much like a belt. If the zone of maximum comfort for a patient falls between two adjustment levels, the patient is forced to choose a setting for the brace that is either too tight or too loose.
Flexible braces that do not employ a snap or buckle fitting often suffer from additional problems. First, many flexible braces are only manufactured in specific sizes and typically do not include sizes for larger people. Second, due to their very nature, many flexible braces fail to adequately control lateral motion. In particular, the brace fittings may comprise soft flexible straps that stretch or constrict excessively when the patient moves. The stretching or constriction of these straps may cause the fit of the brace to become improper, thereby prolonging the patient""s recovery.
Additionally, most braces only provide one set level of support for a patient. The brace either incorporates a rigid splint member into the fittings for support, or may have a single removable splint. However, many patients find that their need for back support diminishes as they heal, and that a brace that continues to provide the initial level of support throughout the patient""s recuperation quickly becomes uncomfortable. Further, the typical back brace only supports the lower back and chest, and fails to provide any support for the upper portions of the back.
Thus, there is a need for a soft, flexible thoraco-lumbo-sacral brace that may be easily adjusted to fit a variety of body shapes and sizes. There is a further need for a brace that provides varying levels of back support, according to the rehabilitative needs of the patient and the patient""s rate of healing. There is also a need for a back brace that provides adequate support for the thoracic and lumbar regions of the back. Finally, there is a need for a brace that provides adequate lateral support in order to minimize unwanted lateral torso motion.
The present invention satisfies the needs identified above. The invention comprises a thoraco-lumbo-sacral orthopedic brace which may be easily and quickly adjusted to fit varying body types though the use of flexible connection straps. A rigid strap placed over the flexible straps serves to minimize undesired lateral torso motion. Lateral panels may be added to the brace to further expand its size and allow for fitting of large patients. Varying levels of back support are provided through the use of a plurality of removable splints. The splints may be added or removed as necessary to match a patient""s support requirements. A thoracic lumbar support dorso-lumbar extension and sternal pad extension unit add additional bracing for the upper back and chest.
Generally described, the present invention provides a thoraco-lumbo-sacral orthopedic brace apparatus formed of flexible materials to fit patients of varying heights and sizes. The brace comprises a flexible anterior support with a large cavity sized to receive a rigid splint. The rigid splint provides back support beyond that provided by the brace alone. Located within the large cavity are multiple smaller cavities sized to receive a series of smaller splints. Each small cavity may contain a single smaller splint. These smaller splints may be used singly or in combination to provide varying degrees of support for a patient, according to the patient""s individual needs. The smaller splints may be used simultaneously with the single large splint in the case where a patient needs a significant amount of back support. The brace may also comprise a posterior support that is similar to the anterior support.
The brace""s anterior and posterior flexible supports are formed of a hook and loop material, and are connected by a set of connecting straps. The connecting straps are also formed of a hook and loop material. A plurality of flexible connecting straps are attached to a second crossbar, which is in turn attached to the anterior support. The flexible straps pass through a plurality of loops connected to a first crossbar, which is in turn attached to the posterior support. The flexible straps are folded over on themselves and attached via the hook and loop material to the anterior support, thus tightening and connecting the various portions of the brace. Because each of the connecting straps is formed of the hook and loop material, any portion of any strap may be attached to the anterior support. A rigid strap is also attached to the first crossbar and passes through a loop attached to the second crossbar. The rigid strap passes over the flexible straps and is affixed to the anterior support. This rigid strap minimizes the flexibility and give of the flexible straps, thus minimizing unwanted torso motion while retaining the brace""s ability to be adjusted to a wide variety of body shapes and sizes. Conventional corset lacing using parachute cord can also be used to help prevent unwanted torso motion.
Flexible lateral panels may be incorporated into the brace in order to further expand its size. The lateral panels are curved to follow the natural curve of a patient""s side and are formed of hook and loop material. The panel is attached to the anterior support of the brace, and the connector straps connect to the anterior support. In this manner, the circumference of the brace is expanded by the width of the lateral stays. The flexible lateral panels further have a cavity sized to contain a removable rigid splint. The removable rigid splint affords a higher level of support to a patient than does a conventional flexible brace.
The lumbo-sacral brace may further comprise a thoracic lumbar support and sternal extension to provide support for the upper back and chest. The thoracic lumbar support consists of a soft, flexible y-shaped body, a pair of flexible straps, a bottom flap, and a cavity. The bottom flap is formed of a hook and loop material in order to allow a patient to attach the thoracic lumbar support to any portion of the posterior support at any height. The cavity may contain a rigid splint in order to provide enhanced bracing to the upper back. A pair of flexible straps connects the thoracic lumbar support to the sternal extension.
The sternal extension may be removably attached to the anterior portion to abut the collarbone of a patient. A pair of loops is attached to the u-shaped padded body which rests against the chest wall. The flexible straps of the thoracic lumbar support are threaded through these loops in order to connect the two supports. The padded body of the sternal extension is connected to a rigid insert by a connector bar. The connector bar may be adjusted to vary the distance between the body and the insert, thus accounting for patients of different heights. The rigid insert is placed within the large cavity of the anterior support, thus providing additional support to the patient and securing the sternal extension to the brace. The lumbo-sacral brace may further comprise a dorso-lumbar extension piece. This is comprised of the rigid material that is inserted into the pockets and is removable. It is attached using screws and barrel nuts. This produces a dynamic unit that serves to pull the patient into hyper-extension, a position that is desirable for most spine pathologies.